Does exercise or splinting in the treatment of trigger finger reduce ...

after 10 weeks of splint wear rather than 6 weeks. There was no significant difference between
those using NSAids and those not using NSAID’s in trigger finger resolution.
• Makkouk AH, et al (2008) Trigger finger: etiology, evaluation, and treatment. Curr
Rev Musculoskeletal Med 1: 92-6
Authors suggest (citing references) that splinting is an appropriate treatment option for those
who do not want corticosteroid injections. They suggest that splinting the PIPJ at night can be
effective for those with symptoms of locking in the morning. States that splinting has lower
success rates in those with severe triggering or longstanding duration of symptoms.
• Fleisch SB et al (2007) Corticosteroid injections in the treatment of trigger finger: a level I
& II systematic review. Journal of the American Academy of Orthopaedic Surgeons;
15(3): 166-171. Database of Abstracts of Reviews of Effects (DARE) 2008
CRD Summary: “The authors concluded that corticosteroid use was associated with an
improvement in symptoms in 57% of patients. Limitations in the literature search, the poor
quality and small number of included studies, and failure to appropriately synthesise the results
mean that these findings should be interpreted with extreme caution”
• Peters-Veluthamaningal C et al (2009) Corticosteroid injection for trigger finger in adults.
Cochrane Database of Systematic Reviews 2009, Issue 1
http://www.mrw.interscience.wiley.com/cochrane/clcentral/articles/535/CN-
0647535/frame.html
Two RCT’s identified with 63 participants. The available evidence for the effectiveness of intratendon
sheath corticosteroid injection for trigger finger can be graded as a silver level evidence
for superiority of corticosteroid injections combined with lidocaine over injections with lidocaine
alone. It states that it is not clear if steroid injection is superior to splinting or surgery in either
efficacy or safety and cites the need for more comparison studies between surgery and
splinting.
• Corticosteroid injections compared to splinting or surgery for trigger finger in adults,
(April 2010), DUETS
A record stating uncertainties identified in research recommendations. States that further
research is needed with RCT’s with adequate sample sizes, better methodology and reporting
according to the CONSORT statement. It recommends more comparison studies between
injection, splinting and surgery, different types and dosages of corticosteroids and different care
settings.
• Trigger finger Map of medicine (July 2011)
http://healthguides.mapofmedicine.com/choices/map/trigger_finger2.html
Recommendations for management of mild to moderate trigger finger:
• Consider referral to occupational therapy to help the patient to use their hand following
injection; splinting if necessary and appropriate.
Splinting:
• a Cochrane review in 2009 recommends that splinting may also be appropriate as a first line
intervention (although not evaluated in the review); however, according to expert opinion
splintage does not work for trigger finger
• rests the joint